As the winter holidays approach, chances are that nearly everywhere you go, youÕll be hearing the voice of Andy Williams singing, ÒItÕs the Most Wonderful Time of the Year.Ó But for some people, the holidays arenÕt necessarily so wonderful.

ÒThe holidays can be tricky for people,Ó says Joe Racklin, PhD, a clinical psychologist in private practice in Fremont. ÒWhile the holidays can be fun, the season also can bring up issues that produce anxiety or depression Ð which often go hand in hand. ItÕs not unusual to experience some sense of worry or get a case of the ÔbluesÕ during the holidays. If your anxiety or depression goes on for more than a couple of weeks and interferes with your life, however, you may benefit from professional help. For people who already have a history of anxiety or depression, the holidays may be even more difficult.Ó

To help people in the community understand more about serious anxiety and depression, as well as various therapy approaches for treating these disorders, Washington Hospital is sponsoring a free seminar featuring Dr. Racklin on Tuesday, November 19, from 1 to 3 p.m. The seminar will be held in the Conrad E. Anderson, M.D. Auditorium at the Washington West Building, 2500 Mowry Avenue in Fremont.

Anxiety Disorders

According to the National Institute of Mental Health, nearly one-third of Americans will experience an anxiety disorder at some point in their lifetime.

ÒThe absence of all anxiety in life is not necessarily a good thing,Ó says Dr. Racklin. ÒYou need to have some amount of concern and worry about important things so you can Ôtake care of business.Õ Fear can help you prepare for threats. We were built to have Ôfight or flightÕ adrenalin-surge responses to threats Ð itÕs a matter of survival. ItÕs an ingenious system, but when it goes awry, people can start to wonder whatÕs wrong with them. They become fearful of their own thoughts and sensations when thereÕs not really a threat.Ó

When someone experiences chronic or more extreme levels of worry, fear or panic, it may be diagnosed as an anxiety disorder. Some common anxiety disorder diagnoses include:

¥ Generalized Anxiety Disorder (GAD) Ð excessive, uncontrollable worries, even when there is little or no reason to worry.

¥ Panic Disorder Ð recurrent, unexpected panic attacks, often with long periods spent in constant fear of another attack.

¥ Phobias Ð abnormally fearful responses to dangers that are imagined or are irrationally exaggerated.

¥ Post-Traumatic Stress Disorder (PTSD) Ð a severe condition that develops after a terrifying ordeal that involved serious harm or the threat of harm, such as sexual assault or the threat of death, with symptoms such as disturbing flashbacks and high levels of anxiety.

One of the most typical responses to anxiety disorders, according to Dr. Racklin, is to avoid whatever caused the anxiety.

ÒFor example, if you experience recurring panic attacks whenever you are in an elevator or are driving down the street, you start avoiding those situations,Ó he says. ÒYou tell yourself, ÔI canÕt go there,Õ or ÔI canÕt drive.Õ While avoiding those situations may help you feel better immediately and provide you with a false sense of safety, avoidance ultimately reinforces your fears and the sense of danger, compounding your anxiety.Ó

Clinical Depression

Avoidance can also be a response to serious depression, Dr. Racklin notes.

ÒPeople who are clinically depressed often pull away from other people and donÕt want to do things they used to enjoy,Ó he explains. ÒThey may remark, ÔI donÕt have the energy to do this,Õ or they might feel that it is Ôtoo much workÕ to take part in activities they formerly enjoyed.Ó

Other symptoms of clinical depression might include:¥ Feeling down, sad or ÒblueÓ more days than not.

¥ Loss of interest in fun or pleasurable activities.

* Changes in sleeping habits, such as insomnia or sleeping more than usual and not wanting to get out of bed.

¥ Low energy levels.

¥ Appetite changes Ð either a decrease in appetite and possible weight loss or an increase in appetite with the person turning to food for comfort.

¥ Self-critical thoughts or a sense of worthlessness.

¥ Looking at the past negatively or looking at the future as bleak.

ÒIf you feel this way for at least a two-week period, you could have a major depressive disorder, and itÕs important to seek treatment,Ó Dr. Racklin counsels.

Good News: Treatment Is Effective!

Anxiety disorders and depression may seem overwhelming, but newer approaches to therapy can be very effective in helping people overcome such disabling mental illnesses.

ÒFor both anxiety disorders and depression, medications may be helpful, but medication may not be the whole answer,Ó notes Dr. Racklin. ÒPeople experiencing these disorders also need to develop life skills that help them overcome their anxiety or depression.Ó

The most researched therapy approach for treating anxiety and depressive disorders is Cognitive-Behavioral Therapy (CBT).

ÒWith Cognitive-Behavioral Therapy, we get people to recognize distorted thoughts and correct them,Ó says Dr. Racklin. ÒCBT can be very effective for many people, helping them identify and challenge the thoughts and patterns related to their anxiety or depression. Sometimes, however, the more you try not to think about things, the more you may think about them.Ó

Newer approaches to therapy include Acceptance and Commitment Therapy (ACT), and other Òmindfulness-basedÓ therapies.

ÒWe look at anxiety and depression as just part of our lives that happen at some point in our lives,Ó he explains. ÒHaving anxiety or depression doesnÕt mean you are a bad person. Clients learn to stop fighting their experiences and accept them, using ÔmindfulnessÕ to reduce the impact and influence of unwanted thoughts and feelings.Ó

At the seminar, Dr. Racklin will explain the processes involved in ACT and other mindfulness-based therapies for various anxiety disorders and depression. ÒThese newer approaches help people walk through difficult times, putting those thoughts into perspective and dealing with them,Ó he says.

To register for the November 19 seminar on anxiety and depression, visit www.whhs.com and click on ÒUpcoming Health Seminars.Ó

Tips for Dealing with Holiday ÔBluesÕ or Anxiety

Dr. Racklin offers a several suggestions for coping with the stresses of the holiday season that may contribute to anxiety or depression:

* Keep your holiday expectations in check, and try to remember what is most important. Make the holidays meaningful and survivable.

* If you are coping with the loss of a loved one during the holidays, be compassionate with yourself and donÕt isolate yourself. Seek the support of people who care about you and share your grief.

* DonÕt overindulge in alcohol to drown your sorrows or give you Òliquid courageÓ to face the holidays, especially if you are depressed.

* Be open to holiday invitations for events you enjoy, but recognize that itÕs also OK to say ÒnoÓ to some activities to avoid burning yourself out.